TY - JOUR
T1 - Reliability, validity, and responsiveness of a novel subscapularis outcome score
T2 - the Baltimore Orthopedic Subscapularis Score
AU - Hamaker, Max
AU - Enobun, Blessing
AU - Kaveeshwar, Samir
AU - Hasan, S. Ashfaq
AU - Shiu, Brian
AU - Henn, R. Frank
AU - Kilcoyne, Kelly
AU - Srikumaran, Umasuthan
AU - Gasbarro, Gregory
AU - R. Zimmer, Zachary
AU - Gilotra, Mohit N.
N1 - Funding Information:
We thank the participants and their families for contributing to the research; Bonnie Addison and Gerard Quarles for recruitment of patients and acquisition of clinical data; and Joel Blankson for recruitment of adult patients for our study. IPDA on the perinatally infected participants' samples was performed by Accelevir Diagnostics. We also thank Joe Szewczyk and Ya Hui Chen for help with GAGLTR ddPCR and subtyping. This research was supported by the NIH (R01 HD080474 [to DP], PO1 AI131365 [to DP], U01 1U01AI135941, [to DP]), the BELIEVE Collaboratory (1UM1AI26617), EPIICAL (16108367), International Maternal Pediatric Adolescent Clinical Trials Laboratory Center (UM1AI106716), and the Johns Hopkins Center for AIDS Research (P30 AI094189). The following reagent was obtained through the AIDS Reagent Program, Division of AIDS, National Institute of Allergy and Infectious Diseases, NIH: ACH-2 cells from Thomas Folks (catalog 349).
Funding Information:
We thank the participants and their families for contributing to the research; Bonnie Addison and Gerard Quarles for recruitment of patients and acquisition of clinical data; and Joel Blankson for recruitment of adult patients for our study. IPDA on the perinatally infected participants’ samples was performed by Accele-vir Diagnostics. We also thank Joe Szewczyk and Ya Hui Chen for help with GAGLTR ddPCR and sub-typing. This research was supported by the NIH (R01 HD080474 [to DP], PO1 AI131365 [to DP], U01 1U01AI135941, [to DP]), the BELIEVE Collaboratory (1UM1AI26617), EPIICAL (16108367), International Maternal Pediatric Adolescent Clinical Trials Laboratory Center (UM1AI106716), and the Johns Hopkins Center for AIDS Research (P30 AI094189). The following reagent was obtained through the AIDS Reagent Program, Division of AIDS, National Institute of Allergy and Infectious Diseases, NIH: ACH-2 cells from Thomas Folks (catalog 349).
Publisher Copyright:
© 2022 The Authors
PY - 2022/11
Y1 - 2022/11
N2 - Background: Available surveys that evaluate shoulder strength and pain often combine rotator cuff muscles making the test unable to differentiate subscapularis tears from other pathology including concomitant supraspinatus, infraspinatus tears. The purpose of this study was to validate a subscapularis-specific shoulder survey (Baltimore Orthopedic Subscapularis Score) as a viable clinical outcome assessment through analysis of psychometric properties. Methods: A 5-question survey was given to a study population of 390 patients, 136 of whom had full thickness rotator cuff tears with a minimum score of 5 (better) and a maximum score of 25 (worse). Surveys were given during the initial consultation, preoperative visit, and postoperative visit. Content validity, construct validity, test-retest reliability, responsiveness to change, internal consistency, and minimal clinically important difference using distribution and anchor-based methods were determined for our subscapularis function survey. Results: A high correlation was reported on test-retest reliability (intraclass correlation coefficient = 0.89). An acceptable internal consistency was reported for all patients surveyed (Cronbach alpha = 0.91). Floor and ceiling effects for patients with rotator cuff pathology were minimized (1% for both). Patients with an isolated subscapularis tear scored worse than supraspinatus/infraspinatus tears and exhibited similar dysfunction as patients with a supraspinatus/infraspinatus/subscapularis tear. An acceptable construct validity was reported with subscapularis-involved tears demonstrating higher scores with significance (P < .05). There was excellent responsiveness to change with a standardized response mean of 1.51 and effect size of 1.27 (large > 0.8). The minimal clinically important difference using a distribution and anchor-based method was 4.1 and 4.6, respectively. Among patients with rotator cuff tears in this population, a score of 22 or higher predicts a subscapularis tear 75% of the time, in spite of its low overall prevalence. Conclusion: The subscapularis shoulder score demonstrated acceptable psychometric performance for outcomes assessment in patients with rotator cuff disease. This survey can be used as an effective clinical tool to assess subscapularis function.
AB - Background: Available surveys that evaluate shoulder strength and pain often combine rotator cuff muscles making the test unable to differentiate subscapularis tears from other pathology including concomitant supraspinatus, infraspinatus tears. The purpose of this study was to validate a subscapularis-specific shoulder survey (Baltimore Orthopedic Subscapularis Score) as a viable clinical outcome assessment through analysis of psychometric properties. Methods: A 5-question survey was given to a study population of 390 patients, 136 of whom had full thickness rotator cuff tears with a minimum score of 5 (better) and a maximum score of 25 (worse). Surveys were given during the initial consultation, preoperative visit, and postoperative visit. Content validity, construct validity, test-retest reliability, responsiveness to change, internal consistency, and minimal clinically important difference using distribution and anchor-based methods were determined for our subscapularis function survey. Results: A high correlation was reported on test-retest reliability (intraclass correlation coefficient = 0.89). An acceptable internal consistency was reported for all patients surveyed (Cronbach alpha = 0.91). Floor and ceiling effects for patients with rotator cuff pathology were minimized (1% for both). Patients with an isolated subscapularis tear scored worse than supraspinatus/infraspinatus tears and exhibited similar dysfunction as patients with a supraspinatus/infraspinatus/subscapularis tear. An acceptable construct validity was reported with subscapularis-involved tears demonstrating higher scores with significance (P < .05). There was excellent responsiveness to change with a standardized response mean of 1.51 and effect size of 1.27 (large > 0.8). The minimal clinically important difference using a distribution and anchor-based method was 4.1 and 4.6, respectively. Among patients with rotator cuff tears in this population, a score of 22 or higher predicts a subscapularis tear 75% of the time, in spite of its low overall prevalence. Conclusion: The subscapularis shoulder score demonstrated acceptable psychometric performance for outcomes assessment in patients with rotator cuff disease. This survey can be used as an effective clinical tool to assess subscapularis function.
KW - Basic Science Study
KW - Development of Outcome Instrument
KW - Outcomes assessment
KW - Rotator cuff tears
KW - Shoulder score
KW - Subscapularis
UR - http://www.scopus.com/inward/record.url?scp=85139825892&partnerID=8YFLogxK
U2 - 10.1016/j.jseint.2022.08.006
DO - 10.1016/j.jseint.2022.08.006
M3 - Article
AN - SCOPUS:85139825892
SN - 2666-6383
VL - 6
SP - 957
EP - 962
JO - JSES International
JF - JSES International
IS - 6
ER -